Polycystic kidneys almost always raise BP

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DEAR DR. DONOHUE: When I was 16, my dad died of polycystic kidney disease. He was only 44. He didn’t know he had it; we found out from an autopsy. What are my chances of having it? I’m 41, and I feel great. How will I know if I have it? – J.A.

ANSWER: More than half a million people in the United States have polycystic kidney disease, and that makes it a pretty common inherited illness. In most instances, it’s passed on by what’s known as autosomal dominant inheritance.

That means it takes only one gene, from either parent, for the child to have the condition. If one parent has the polycystic gene, then half of the children can be expected to also have the gene. There are other varieties of polycystic kidney disease, inherited differently and having different implications, but autosomal dominant is the most common kind.

Signs and symptoms of the illness usually appear in the 20s and 30s. You are in your 40s and have none – a good omen. An all-but-universal sign is a rise in blood pressure. Side pain from large, cystic kidneys is another symptom. Episodes of acute and intense pain in the area of the kidney are common, and they’re due to a stone or a blood clot blocking the egress of urine from the kidney. Urinary blood, visible or seen only with a microscope, is another common sign. Recurrent kidney stones are a tip-off. So are frequent urinary tract infections.

Since you have had none of these, that makes your chances of having the illness less likely.

Proof can be obtained through an ultrasound of the kidney or through a scan.

Treatment of polycystic kidney disease involves treatment of high blood pressure and urinary tract infections. Such treatment slows deterioration of kidney function.

If the kidneys do fail, there is always dialysis and kidney transplantation.

Why don’t you pursue this by calling on the Polycystic Kidney Disease Foundation? The toll-free number is 1-800-753-2873. The Web site is www.pkdcure.org.

DEAR DR. DONOHUE: My wife is scheduled for endovascular laser therapy on her right leg for varicose veins. She has had the left leg already done. If she needs a heart bypass later in life, how will she be able to have it, since both leg veins are gone? – J.N.

ANSWER: If your wife ever needs heart bypass surgery later on, and let’s hope she never does, the surgeon can use an arm artery rather than a leg vein. Arteries actually make better bypass grafts than veins. They are sturdier than veins, and they last longer. Taking an arm artery doesn’t shortchange the arm of its blood supply. There are more than enough arteries to the arm that losing one doesn’t impair circulation to the arm.

J.N.’s wife is having a somewhat-new procedure for varicose vein removal – endovascular laser therapy. A doctor inserts a laser fiber into the varicose vein. When he or she reaches the desired point with the fiber, laser energy is released, and the vein collapses. Its walls stick together. Goodbye varicose vein.

This procedure is an excellent one, but it’s not for everyone. People with varicose veins should talk to their doctor about the many options they now have for getting rid of such veins.

The varicose vein report presents detailed information on this common problem. Readers can order a copy by writing: Dr. Donohue – No. 108, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Occasionally, my eyelid twitches. Is that abnormal? – R.P.

ANSWER: Most people have a twitchy eyelid at sometime in their lives. The twitching comes from contractions of the eyelid muscles. If it bothers you, gentle massage can put a stop to it. So can warm compresses to the closed lids.

There is a condition of involuntary eyelid closure that can be so prolonged it makes a person virtually blind. It would be next to impossible to confuse this condition with the harmless kind of eyelid twitches so many have.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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